Liu J, Liu Y R, Wang Y Z, Han W, Chen H, Chen Y, Wang J Z, Mo X D, Zhang Y Y, Yan C H, Sun Y Q, Chen Y Y, Wang Y, Xu L P, Zhang X H, Liu K Y, Huang X J, Chang Y J
Institute of Hematology, Peoples' Hospital, Peking University, Beijing 100044, China.
Zhonghua Xue Ye Xue Za Zhi. 2018 Aug 14;39(8):617-623. doi: 10.3760/cma.j.issn.0253-2727.2018.08.001.
To assess the prognostic significance of immunophenotype complete remission (ICR) and hematological complete remission (HCR) before human-leukocyte antigen (HLA)-matched sibling donor transplantation (MSDT) in acute myeloid leukemia (AML) patients. A cohort of 182 AML (non-APL) patients undergoing MSDT in HCR was retrospectively studied [including complete remission with ANC and PLT recovery (CR), CR with incomplete PLT recovery (CRp), CR with inconplete ANC and PLT recovery (CRi)]; ICR was determined as undetective minimal resudial disease (MRD) by multi-parameter flow cytometer. ①Of the 182 patients, 97 were male, 85 female, and the median age was 41(4-62) years. ②The CR and CRi+CRp rates were 80.8% (147/182) and 19.2%(35/182), respectively; The 4-year cumulative incidence of relapse[CIR, (11.0±4.3)% (16.0±7.1)%, (2)=0.274, =0.600], non-relapse mortality[NRM, (14.0±4.3)% (9.0±6.3)%, (2)=0.913, =0.339], leukemia-free survival[LFS, (75.0±5.1)% (75.0±8.3)%, (2)=0.256, =0.613], and overall survial [OS, (77.0±5.2)% (80.0±8.1)%, (2)=0.140, =0.708] were comparable between the CRp+CRi and CR groups. ③Compared with the non-ICR group (=35), the ICR group (=147) showed lower 4-year CIR [(11.3±3.4) % (55.2±8.8) %, (2)=32.687, <0.001], better 4-year LFS [(76.2±4.7)% (32.8±8.7)%, (2)=26.234, <0.001] and OS[(79.0±4.7)% (39.0±9.1)%, (2)=25.253, <0.001], and comparable NRM[(12.5±4.1)% (12.0±7.1)%, (2)=1.002, =0.656]. ④Mulitvariate analysis confirmed the independent prognostic value of ICR in lower CIR [=11.026(95% 4.685-25.949), <0.001], higher LFS [=5.785 (95% 2.974-11.254), <0.001] and OS[=5.578 (95% 2.575-27.565), <0.001]. The results indicated that ICR instead of HCR pre-transplantation had a significant prognostic value in AML patients undergoing MSDT.
评估急性髓系白血病（AML）患者在人类白细胞抗原（HLA）匹配的同胞供体移植（MSDT）前免疫表型完全缓解（ICR）和血液学完全缓解（HCR）的预后意义。回顾性研究了182例接受MSDT且处于HCR状态的AML（非急性早幼粒细胞白血病）患者队列[包括中性粒细胞计数（ANC）和血小板（PLT）恢复的完全缓解（CR）、PLT恢复不完全的CR（CRp）、ANC和PLT恢复均不完全的CR（CRi）]；通过多参数流式细胞仪将ICR确定为未检测到微小残留病（MRD）。①182例患者中，男性97例，女性85例，中位年龄为41（4 - 62）岁。②CR以及CRi + CRp率分别为80.8%（147/182）和19.2%（35/182）；CRp + CRi组与CR组的4年累积复发率[CIR，（11.0±4.3）% （16.0±7.1）%，χ² = 0.274，P = 0.600]、非复发死亡率[NRM，（14.0±4.3）% （9.0±6.3）%，χ² = 0.913，P = 0.339]、无白血病生存率[LFS，（75.0±5.1）% （75.0±8.3）%，χ² = 0.256，P = 0.613]和总生存率[OS，（77.0±5.2）% （80.0±8.1）%，χ² = 0.140，P = 0.708]相当。③与非ICR组（n = 35）相比，ICR组（n = 147）的4年CIR较低[（11.3±3.4）% （55.2±8.8）%，χ² = 32.687，P < 0.001]，4年LFS更好[（76.2±4.7）% （32.8±8.7）%，χ² = 26.234，P < 0.001]，OS也更好[（79.0±4.7）% （39.0±9.1）%，χ² = 25.253，P <
